The Physician Wellness Movement and Illegitimate Authority: The Need for Revolt and Reconstruction

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Letters From Those Abused and Afraid

I get many e-mails, letters and phone calls from doctors, nurses and others who have been abused by “professional health programs” (PHPs).

Most are anonymous. Afraid of being identified and punished by the PHP, very few leave comments on my blog revealing their names or potentially identifiable information.

This is understandable. By simply reporting “noncompliance” to the medical boards a state PHP can end their careers. As it was with the Inquisition this system relies above all else on silence and secrecy. Speaking out can result in “swift and certain consequences.”

They are afraid. Some are undoubtedly suffering from PTSD. Most have developed a “learned-helplessness” Many have reported abuse and even crimes to their medical societies, medical boards, law enforcement, the media and others only to have the door slammed in their faces.-myself included.. They have no advocacy or support and feel no one cares. Their locus of control, identify and self-worth have been suddenly ripped from them without recourse. There is no lifeline. Attempts at justice are often undermined by a concerted defiance of the truth by their medical boards and even the attorneys who are purportedly working for them but will not “bite the hand that feeds.”

PHPs are ostensibly Employee Assistance Programs (EAPs) for doctors in both mechanics and mentality. EAPs assist employees with substance abuse, personal problems and other issues. They do not diagnose or treat “patients” but refer to outside professionals who do. The critical difference between EAPs and PHPs is PHPs have mandated all assessment and treatment be done by their own. These “PHP-approved” facilities are economically and ideologically intertwined with the PHP. The conflicts of interest are serious and many.

PHPs also use non-FDA approved junk-science drug and alcohol testing they introduced. The procedural safeguards most EAPs use to protect the donor ( certified labs, FDA-approved validated tests, split-specimen, strict chain-of-custody, MRO review) have been reviewed. Unvalidated “personality” assessments they also introduces are being used in “disruptive” physician evaluations guaranteed to find “character defects” to justify monitoring contracts. They implement polygraphs despite the AMAs previous conclusion they are scientifically unsupportable.

But regulatory agencies have readily adopted policies not only unsupported by science and evidence-based research but outside the normative principles and practice of medicine.

Granting PHPs authority to limit assessments and treatment to their own facilities offends the fundamental rights of the individual.

Informed consent (or refusal) constitutes a basic rule of the lawfulness of medical practice according to national and state medical practice acts governing the profession. It is a basic principle of all published principles of medical ethics.

Involuntary treatment is motivated by either potential harm to others (for the good of society) or by need for treatment and/or potential self harm.

Involuntary treatment should be a confined to those gravely disabled by psychiatric disorders or substance abuse. It necessitates reflection under the ethical principles of autonomy and beneficence.

A single DUI, transient psychological issue such as grief or anxiety, and even sham peer-review can easily land a doctor into forced assessment and involuntary treatment at a “PHP-approved” facility.

How is it this paradoxical assessment and treatment paradigm legitimized and justified within a profession that emphasizes evidenced based decision making and beneficence and autonomy as two of the basic principles of medical ethics?

To sell the “PHP Blueprint” to other EAPs it is necessary to prevent doctors from speaking the truth. Very few want their names, states or other unique identifiers published for fear of consequences and retaliation.

The letters below have only been posted after being approved by their authors-MLL

12/14/16

Comment: This whole lack of accountability and oversight within the PHP’s makes me sick. I was sent to PHP for evaluation and suspicion of drug abuse by my employer hospital. I was only suffering from side effects of Paxil causing a SSRI Discontinuation Syndrome. The diagnosis was completely missed because the PHP sent me to a rehab center in Los Angeles. I am sure you know this one very well. I was coming there for IDE, Intensive Diagnostic Evaluation not recovery and rehab. After arrival I was forced to enter their rehab program completely against my will. I was on my way out the door and about to call a cab when the program director threatened me with absolute coercion. He said if I left he would assume I had drugs in my possession and that this would negatively affect my evaluation and would be reported to the PHP and state medical board as a form of noncompliance, and that my career and license would be in jeopardy. How is that possible when I was not sent there by any state board or regulatory agency as I was there voluntarily. The only incentive to force me into admission rather than having my workup done as an outpatient was purely financial. Employer was paying the bill, so it was in their best financial interest to force me into admission at $1800/day and $1400/urine sample and charge for all the transportation to and from all the outsourced facilities for my “evaluation”. The facility was run by the most inept, unethical group of charlatans I have ever encountered in any field of service not just healthcare. I could not understand how they were qualified to provide medical evaluations when they are not legally allowed to provide any form of treatment for anything. These people were nothing more than middle-management screw ups. They have to outsource everything. They did not even have a crash cart on site. One of their clients had a tonic-clonic seizure during group therapy as a result of a brilliant PA who decided to withhold the clients chronic benzodiazepine therapy because of her personal beliefs that benzos are horrible medications for anyone. Where is the physician co-signature and oversight on this brilliant therapeutic decision? No one except the doctors in rehab even knew how to react. It was a total fiasco and state of panic for all the rehab employees. Luckily the client didn’t dislocate something, die or worse, suffer anoxic encephalopathy. I was in fear for my life after witnessing this my first day. What’s even more concerning is that this rehab center is supposedly one of the best and has exclusive referral from every state PHP.

They had me stay with recidivist junkies and participate in 12 step when I had no substance abuse issues at all, in fact my social life was so boring, that my hair test wasn’t even positive for alcohol. I had to recite scriptures in group therapy, admit that I was helpless, and powerless, and a weakling. Admit that I had to submit to a higher power since I was an addict. I had to submit to random urine drug tests which costs $1400 each 3-5 times per week. Then when I cannot produce a sample on the spot (paruresis) I am threatened to be reported to the State Medical Board for noncompliance. A college dropout working as a technician at a rehab does not even have the authority to make this type of threat. I was also forced to shave in front of a female technician with the bathroom door open; she stated that this was policy and I had to relinquish my razor after every shave because I could use it to inflict harm on myself. I then asked why is there a whole drawer full of sharp cutlery in the kitchen that me and my junkie roommates have access to 24/7???

I saw a psychiatrist and handed him my diagnosis on a silver platter from my history , i.e. Paxil withdrawal yet SSRI Discontinuation Syndrome was not even on his differential. I was in a state of constant agitation, sleep deprivation from insomnia, severe depersonalization. Ended up in the ER at UCLA for intractable Migraine HA, Sleep deprivation, Dehydration, mild AKI and had to be medicated with IV crystalloid, Phenergan to combat emesis and finally induce sleep (going on 4th day of insomnia at that point).

Less than 24 hours after the ER visit I am sent for Neuropsychological testing extensively, which violated just about every code of conduct and ethics under the American Psychological Association in regards to testing validity. I was then labeled “disabled” based on the results. Promises was then going to recommend that I stay and additional extended period so they could “rehabilitate” me. They realized now that they did not have my credit card on file because I refused to provide them with it at admission as Kaiser Permanente, my employer, was paying for everything for the first month. Next they discover that I do not have disability insurance, and now know that they have just ruined my life. It will take a minimum of 6 months before I can be retested to prove that I have no cognitive impairment and am not disabled. Now my chances of getting disability insurance in the future are ruined.

Promises then released me and I returned home to the PHP. I then had to sign a five year contract, enlist in a drug monitoring contact with “RecoveryTrek” which I had to perjure myself and illegally claim that I was a substance abuser and was in “recovery.” I immediately sought legal counsel because of this nonsense. Shortly into my so called recovery I had to take my Maintenance of Certification Board Exam in Internal Medicine. Passed exceptionally and with ease. How could I be cognitively impaired? Go figure! The neuropsychological test was readministered locally by a different provider as I told the PHP there was no way I would ever consent to going back to Promises. The neuropsychologist was pretty pissed off about everyone’s mismanagement of my case starting with my employer. I tested fine, and then the PHP released me from the program and cleared me to return to work. The entire experience has jaded my enthusiasm in medicine. I had to take almost a year off to reflect on how I was used as a pawn in everyone’s game. I experienced coercion, collusion, fraud, incompetence, and saw a part of evil in this world that I never new existed. I was a prisoner, starting my day by having to call a monitoring center to see if I had to be drug tested for that day, every day of the week. I was not allowed to leave the state; how can a PHP legally restrict my civil rights this way when I was not under a court order, and not even under state medical board referral? I was not allowed to have a sip of alcohol during my monitoring, even though I had tested negative for any evidence of drug use. I had to meet with board of directors every month and discuss my case, which no one had clue about regarding why I was even in a PHP. This violated all of my rights to privacy regarding my medical condition. The contract that I initially had to sign with the PHP had statements within claiming they could report any information about me to any regulatory agency without even substantiating any facts or validity. This is just a clever way of saying they can lie about you and there is nothing you can do about it legally. There is complete lack of due process. Your civil rights are stripped. You are beaten down into despair and desperation. You are told if you don’t comply your license would be in jeopardy and your career will be over. This cost me thousands of dollars in legal fees, thousands of dollars to be retested and prove I was not impaired, hundreds of dollars each month for PHP dues and random urine drug screening.

I put up with this B.S. for six months, and honestly could not have fulfilled a 5 year contract. If I had not been released (since there was no condition to monitor) I would probably be dead today. I would not be surprised that PHPs have actually caused in increase in physician suicide rate. I cannot fathom the degree of humility physicians experience having to do this for five years. And the only reason these rehab centers claim such a high success rate for recovery is that they hold a gun to your head and threaten you to be in compliance with everything they recommend. So yeah, doctors have a lot more to lose. I now understand how these PHP’s are in collusion with rehab centers. What they are doing is a violation of fair trade acts and would fall under the RICO act. The problem is nobody is investigating them for conspiracy and fraud. They all fly under the radar because they believe they are providing a service that ensures public safety. Its a multi-billion dollar scam industry. What’s more sad is that nobody really cares what physicians are subjected to. In fact the public likely finds joy in fact that docs are treated this way. The state of California hates doctors, so the rest of the country probably does too. People probably enjoy knowing doctors are held to higher standards than the rest. That they are usually required to stay 90 days in rehab while all other professionals stay 28 days, that they are financially ruined by rehab centers. That they have been stripped of all their rights while in a PHP monitoring program. That they are more subject to discrimination based on age or coexisting medical problems like diabetes and hypertension. I have actually seen cases of MDs sent to PHPs for monitoring of hypertension and regardless of why you are sent there you must comply with drug monitoring.

The rehab centers are now tapping into other territory that further identify this as a conspiracy. Department of Transportation, Aviation, and Law Enforcement are going to be their next victims. I can’t wait to see how the police officers are going to respond to this nonsense.

This was an eye opening experience. There is no profession that is worth going through this amount of humility. PHP’s will likely remain above the law, continue to have no accountability and oversight, which is a travesty of justice. I hope you will share my experience. My case is rather unique in my opinion. It’s evidence that no physician should ever voluntarily enter a PHP at an employer’s request. You would be much better off to simply quit/resign.

10/30/16

I am an RN caught up in the State of Florida’s version of this mess. While yes, I deal with a psychiatric diagnosis (Bipolar 2), up until a single episode of depression that spectacularly manifested itself in a suicide attempt involving a drug overdose (that thankfully failed), I did fantastic. I got through nursing school and had a stellar career. At a certain point, I developed a lot of physical health issue that no doubt precipitated that act. Upon that incident I landed in the PHP mill of evaluation and treatment nightmares, complete with the conflict of interest exactly as stated in other letters.
After a huge amount of money spent on inappropriate drug/alcohol treatment, damage to my relationship with my family, and lopping my career off at the knees, I have been forced to submit to a boilerplate contract that is broad and ambiguous to the point of essentially allowing the program to do what they want, when and how they want. There is a lot of inconsistent interpretation and inconsistent enforcement of their so-called “policy.” (which seem to be invented and changed as they see necessary at the moment.)
With my license and livelihood held hostage, i am forced to submit myself to multiple humiliating tasks. I am coerced to AA meeting attendance, even though I have never even drank. I question how attendance at a religious organization can be required to retain my state-issued license. i will be in this dystopian world for 5 years. I have made it through two and pray that I will get through the next 3.
I do not deny that I needed some type of help when in the throes of that particular down swing, but this was not it. SIX months of drug/alcohol treatment, 12 step indoctrination and the like only served to make my fight even harder.
Thankfully, my medication regimen is well balanced now and I have a fantastic therapist and psychiatrist. Seeing both is a stipulation to the contract and I have no issue with that. I do not take issue with the monitoring aspect so much as i do with the net being cast so wide that very competent professionals with anything from true addiction issues to mental health to merely a penchant for bad judgement (how does a 15 year old DUI make a person an alcoholic.”) are scooped up and dumped in a large bucket and labeled “unsafe to practice.” That bucket is owned and run by these PHPs. To paraphrase a statement I once saw “yes there are people that should not be practicing except under the eye of such a program but there are many, many more whose lives and careers are forever ruined by these harsh and draconian punishments.
The programs claim to “advocate for the impaired nurse.” I see little to no advocacy and a lot of punishment, mostly I believe in the pursuit of the almighty dollar with no care of the fact that there are real human beings on the other end of the rope that is being yanked. It is even worse that the perpetrators of this horror are the physicians that once took an oath “to do no harm.” They must have forgotten that.

9/27/15

I was a victim of human rights violations committed by the PHP farmed out the group called Maximus. While in the “Diversion program” with 18 month clean sober, over 130,000 invested to date, I fractured and dislocated my shoulder. When arriving in the ED I told the MD of my circumstances and requested a drug test as part of my in addition to standard radiographs. The ED MD ordered IV pain medication right away seeing my pain. I refused, until I could reach my “diversion nurse counselor”. The ED doc consulted Pain Management and Ortho given the added level of complexity. Ortho advised that they immediately give me dilaudid and place my fractured shoulder back in socket as my hand was numb and my pulses were weak., then I be admitted for surgery. When I finally reached the PHP monitor, her she told me that if I “take anything other than tylenol ( including for surgery)she would have my license” My team of 4 physicians now at this point( a hospitalist, ortho, PM and ED) all agreed that this was ill advised and I must have my shoulder placed back into socket immediately. That assuredly, this nurse knew not what she spoke and as soon as Monday morning came and they could contact the medical board….I would certainly be vindicated”post-procedure”, as even my contract read,that “medical care recommended by a reasonable licensed physician could not be prohibited” by participation in the program. I let the orthopedist, give me dilaudid and reduce my shoulder. I was admitted to the hospital for one week, while the Orthopod tried to induce me to have the surgery. Pain Management managed my acute pain, with full knowledge of my situation. All the doctors tried to contact the medical board to tell them of my unique surgery. That I should not be kicked out of the program. And, I should have the surgery I needed. The medical board took my license. Upon discharge from the hospital, the the medical board detectives came to my door to inform me, that I couldn’t work. I knew I could not even get myself dressed. When the board detectives came to take my license I had my hospital wrist band on one hand, and a wrist band circulating around our beach community of Ladera Ranch, for the little girl whom I was just featured in the newspaper and on TV for saving her life. They told me I was a danger to the public. My life fell apart. It has never been the same. I had already paid some 130-160,000 in fees to the PHP, and related expenses, even though I “had a strong case to fight the board” as one attorney said. I had no more money left. They had taken everything from me. My life was over. Suicide is something I still think about as I try to piece my life together. There were human rights violations occurring. There were anesthesiologist in Diversion forced to have “back alley” surgeries while in the program, at their friends surgery centers, using diprovan, as it wasn’t checked for. If you had a minor surgery or God forbid a situation such as mine….you were kicked out and lost everything.

6/25/15

Kudos for bringing this to light. I wish to remain private but I developed PTSD at one of these programs as a result of misdiagnosis and the bullying you describe.

I became suicidal after months of “treatment”. I was discharged after my funds and all I could borrow were exhausted.

Nightmares every night for 6 years and my life forever changed.

Keep shining light on this.

5/21/15

Sinical Surgeon
The word of the day is “GESTAPO “, as a noun it is defined as; The German internal security police as organized under the Nazi regime, known for its terrorist methods directed against those suspected of treason or questionable loyalty.

As a verb the definition is; Of, relating to, or characteristic of terroristic police methods or operations: gestapo tactics. The verb definition is what I’d like to focus on.

When I was accused of wrong doing by a two time relapsing, drug addict, I was referred to the Physicians Health Program (PHP) in my state of practice. Under the guise of an organization set up to help physicians, I was taken back by the change in demeanor of the head of the program, when I refused to enter a recommended treatment facility… for I had been presumed guilty without any due process.

I refuted their allegations that I was a drug addict and decided to obtain an attorney to prove my innocence. The whole ordeal was initiated by this relapsing drug addict who got caught using drugs… to save his ass, he came up with stories about a number of people in the community.

The police couldn’t find any proof of his allegations towards me so they arrested me on a bogus charge (a KASPAR violation which is giving information about a patient to someone whom is not a patient of yours) I was the first person ever to be charged with that violation in the state.

Needless to say, the incompetent police department didn’t do their homework, because the person I gave information to was my patient. Those charges were eventually dropped but not before the police department had requested that the State Medical Board order me to have a hair test (they were alleging that I sold drugs out of my home) I was making 400K a year on average… I don’t think I needed the extra income.

Once the PHP got involved, my career as a cardiac surgeon was doomed. When I challenged the allegations and objected to their GESTAPO tactics…, the director of the program told me that they (the PHP) were immune from prosecution for false accusations and that he was going to “bury” me… That he did.

I was ordered to give a hair sample, which came back grossly positive (in the range of a heavy daily use). Had I known then what I know now, I would have asked for a DNA match for the hair sample…

I know in my heart the sample was tampered with and I now that this evil former drug addict himself, (the director of the PHP), arranged it.

From that point on my life has been a living hell… a virtual legal nightmare due to the domino effect that State medical boards employ. I’m still in limbo, my purgatory. I grieve for my fallen career and I prey I continue to have the strength to live and let live. ‪#‎wordofthedayss‬

4/20/15

Dear Michael Langan

I love your writings analysing the power relations and psychopathy that is running rampant in every sphere of life, including sadly, medicine…

Your logo of the the two serpents represents the fight between good and evil, to me…

It was encouraging that you ‘liked’ the post from the blog as writing in relative isolation is very hard.

So thanks a bunch !

Take good care of yourself – truth tellers are precious and rarer than gold dust !

3/5/2015

Comment: I am Board Certified in Internal medicine. I have endured years of emotional, psychological and spiritual abuse at the hands of the Washington Physician’s Health Program. I have suffered through a long list of injustices without recourse. They include, but are not limited to discrimination, abuse of power, breach of contract and repeated and WILLFUL medical negligence.

Because the actions of the WPHP have been SO egregious, I assumed what was happening to me must be extraordinarily rare.

I have nothing to hide. And I have shared my story with any and all who would listen. To date, my voice, my rights and now my life have been dismissed as unimportant. MY LIFE!! It’s apparently better that I die than my tormentors be questioned and compelled to defend their indefensible and evil behavior.

I am meeting with one last attorney tomorrow. I fully expect him to ignore the basic, indisputable and well documented facts of my case. Namely, there is massive and systematic malfeasance being committed by a tax payer funded agency in the State of Washington who act with omnipotence and without oversight. I have no reason to believe he will respond any differently than the others with whom I have met. HE WON’T CARE! HE WILL NOT BE MOVED. He will make statements that suggest I DESERVE this treatment. And that my life, as well as my imminent death, is unworthy of his time or efforts.

Once my assumptions about this last meeting are officially confirmed, I am committed to the only course of action available to me. The only thing which will put an end to this nightmare.

Today I stumbled upon your website. And today, for the first time, I have learned that my case is not rare. I suspect the other physician victims in this matter have occasionally allowed themselves to dream wistfully of justice. Justice which they have seen thwarted at every turn. Perhaps they, like me, have dreamily imagined the relief and joy and LIFE they would experience if the truth were simply presented and the perpetrators held accountable. I have imagined standing up in court and triumphantly affecting justice for myself as well as all of the other current and future victims. I deliver a powerful defense of justice. My ‘dream speech’. I have imagined that I might still live. And then I wake up.

And so today, imagine my shock, when I found my ‘dream speech’ here. My speech. Reasonable. Honest. Consistent. And based firmly in truth, justice and defense of the powerless against the (arbitrarily) powerful. My speech, it seemed, but authored by another.

Thank you, Dr. Langan. You have given a voice to my struggles. Please never stop speaking for me, and people like me, many of whom, I fear, will not survive to see justice.

Despite my intention to die, I actually WANT TO LIVE! And I will live and fight on if I ever believe that there is even a small chance of justice for me and the other innocent victims of PHP’s and the ‘treatment’ centers with whom they contract (Talbott in my case. Purely evil and loathsome human beings, for the record).

So, because I do WANT to live…PLEASE HELP ME, SIR!

Can you refer me to attorneys, individuals or groups who might advocate for me and the other victims? Do you have any specific words of hope or encouragement?

Please note my name. Please add me to the list of innocent victims of these power hungry, narcissistic BULLIES.

I don’t expect to live through this. And in a way, the PHP, Talbott and the addiction ‘experts’ with whom I have been tragically acquainted are correct…My life is worth very little. But this issue is so much larger than I. I can die with some serenity if I believe there will be meaningful justice for others like me. And that those responsible will be held to account.

Thank you Dr. Langan. Thanks to all of those involved in the creation and maintenance of this website. Although your shining beacon is barely perceivable through the darkness of injustice which surrounds and seeks to extinguish it…it is the only glimmer of hope I have found during my slow death by PHP.

3/2/2015

Dr. Langan:

Thank you for your articles and research regarding PHPs and “impaired” physicians. I have become involved in this issue after someone close to me struggled with depression during residency. Sadly, they lacked the resources, support and coping skills and ended up committing a crime with a misdemeanor charge. Despite their treatment and rehabilitation, they were dismissed from residency. Not sure if they will ever get to practice clinical medicine. It is very sad. they are very smart, great doctor and very empathetic towards patients.

After their situation, I started looking on blogs and found that many residents had shared similar instances. Many reported struggling with depression and the stresses of residency put them over the edge– like the perfect storm of stress, fatigue, and loneliness that could exploit anyone’s weaknesses. It seems like during residency, we are emotionally as well as legally vulnerable. Many of these residents have never been able to resume training at their institutions despite their demonstration of clinical competence and emotional maturation. According to that medscape article, that is a huge loss to society, socially and financially.

Sadly, there still so much stigma surrounding mental health, and I think it may be worse in our profession.

I am very concerned regarding the future of our profession. We are becoming robots in a health care factory. Our own personal lives are being compromised as well as quality patient care.

I appreciate all you are doing to shed light on this very important issue.

Thank you for your time and consideration

2/17/2015

Dear Dr. Langan:

Thank you for your insight, eloquence, and concern for all of us. These Boards and other administrative bodies claim that they are “protecting the public,” but healthcare providers are the public too. And they’re killing us.

The problem is not unique to physicians. I am a nurse practitioner, and we share some of the same burdens. Although the numbers are growing, there are so few NPs nobody has studied suicidality among our profession. There is still the same fear of malpractice, professional bullying (nurses “eat their young,”) and the taboo of asking for help.

A trivial, third-party complaint to the State Board didn’t cost me my license, but it did cost me my job and my mental health. The pain I endured: the relentless questions about my personal life… it was jarringly intrusive. All of this was conducted by a bullying investigator: a man who had no medical training. The Board took it upon itself to ask detailed questions about my personal life and relationships, as if they would somehow psychoanalyze me. The investigator started his conversation by advising me that the Board does not honor the Fifth Amendment.

I’ve heard others—physicians—tell me of similarly murky complaints that dragged on. A cardiologist I know was instantly fired and rendered unemployable for year under similar circumstances. He struggled to feed his kids. Nobody died. Nobody got hurt. He didn’t have a substance abuse problem or divert drugs. He practiced within his scope. The case was eventually dismissed, and he’s back in business. But he has never totally recovered.

A simple, free email to the Board can cost a physician or nurse practitioner his or her livelihood in a split second.

All of this detracts from the dangers posed by inept or otherwise dangerous clinicians. We’ve all met them, seen them in practice, seen their charts, or heard stories. I think everyone I know can name a clinician who showed up drunk to work, billed fraudulently, or who was so incompetent that he or she should not be practicing.

It has been ten months. The Board hasn’t had any further questions, but they never dismissed the case, claiming that they have a massive backlog. My health and livelihood are inconsequential to them. I’m still being prescribed scheduled benzos and z-drugs just so I can make it day to day.

I came very close to suicide more than once, but I evaded psychiatric admission because then I’d lose my license without a doubt. Again, “protecting the public?” I deliberately avoided emergent medical care because of the Board.

I chose another path: I left the profession, and I have lost my sense of self. Twelve years of school, $350,000 in tuition, and four degrees were rendered worthless by a single third-party email. Above all, my pride in my clinical acumen, passion for learning, anal retentive charts, sensitivity, and professionalism also went down the drain.

The Board’s notion of “protecting the public” also means kicking good providers out of the business. Our emotional lives are destroyed, our finances wrecked, and we live in fear. There is no “speedy and public trial,” no “jury of our peers.” Although Conrad Murray MD fled to Trinidad, where he is working as a cardiologist (hopefully not prescribing propofol for insomnia), an open complaint renders me ineligible for licensure in all fifty states, all Canadian provinces, the Netherlands, and Australia.

Assuming that the Board dismisses the case, I don’t know if I could ever return to practice. It’s too hard to live in fear of a backstabbing patient or family member, and the ineptitude and glacial pace of a medical board. I want to clobber anyone who says, “and this too shall pass.” It’s not quite like that.

I am trying to re-establish myself in some second career, but that is hard to face. I cringe every time I open my email and mailbox in fear of a letter from the Board. I know I did nothing wrong, but that’s not how the system works.

I still fight the urge to take my own life.

1/17/2015

Great website. Presents an alternate view I have never seen in action and I have had to report a number of MDs to our state’s PHP. Thanks for the insights.

2/8/2015

I am an RN in a monitored program in PA which includes forced AA attendance. I have 22 years as an RN with 10 years of military service which includes a one year deployment to Iraq. I am willing to speak out. Too many are afraid of losing their licenses to practice.

There are a variety of theories on why physicians commit suicide. Depression is the most common explanation given. Certainly, there’s a lot of stress involved in our profession. We deal with death and dying. We’re held to impossible standards. Managed/mangled care and the restrictions of government plans/laws/policies on the one hand restrict what we can do for our patients. On the other hand however, are the viscous packs of attorneys waiting to cull the herd. Let’s not forget the State Medical Boards, out there striving to “protect the patients”, generally done in cahoots with the “Physicians Health Programs”. These two entities form a deadly collusion that is inescapable—and of course, linked to the packs of predators circling to ensure that we will suffer the consequences for actions that we may have little if any control over.

I am one of the unfortunates.

I haven’t committed suicide (obviously), nor made an attempt at it. Certainly I’ve had thoughts about it—who among us hasn’t? My strong religious convictions prevent any serious consideration of this “permanent solution to a temporary problem”.

I am also one of the fortunates.

This is largely due to the foundation of faith that I have. Years ago I made what may have been a mistake. I prayed for patience & humility. We tend to be an impatient and yes, at times an arrogant lot. I recognized those character flaws in myself and asked Him for help.

I should have asked for the grace to overcome these shortcomings. Grace is a gift, a “freebie” if you will.

Patience is gained through trials. Humility generally through humiliation.

I have learned that where there is pain in life, there is often a lesson—look for it, learn from it. Running from it merely guarantees that it’ll be presented again, and again and again until it’s learned, often with a few extra presentations after the initial effort to dodge the trial.

The study of theology has lead to the interesting concept that suicide is actually a sin of pride. Yes, depression is involved, but the pride plays it’s role with the thought that; “I don’t deserve this trial so I’m choosing to take myself out of the game”.

My personal belief is that only God has the power to give and take life. The reader is certainly entitled to their own belief. Mine has evolved by study and prayer over decades.

There is a growing movement afoot across all 50 states for attorneys employed by State Medical Boards to direct their investigators to report possible transgressions directly to the attorneys instead of to the physician board members http://woundedhealersnc.net/. The attorneys have thus usurped the role of a professional board; to ensure that we’re held accountable by our peers. These attorneys then draft their own perspective of what happened, often putting “spin” or “slant” to the report to prejudice the board members to carry out the actions that these attorneys deem to be appropriate. The Board Members have unwittingly abdicated their responsibilities. This leaves physicians at the mercy of Board attorneys. These attorneys were initially tasked with ensuring that the Board members didn’t violate any laws in their disciplinary actions against wayward licensees. Board members are busy physicians in their own rights. They have their practices and with the attendant problems associated with them, as do the rest of us. Typically, they go to their state capital for a couple of days a month to do their “official duties”. The attorneys present the information for the “rubber stamp” of the Board’s approval.

Worse still are the “consent orders” drafted by the State Board attorneys. A key part of such an order is the “findings of fact” describing the (alleged) transgressions. The hapless licensee is often coerced to signing these flagrantly fictitious documents with threats that the attorney-derived discipline will be much lighter than what the Board will mete out. It’s actually not uncommon for “defense” attorneys to collude with the Board attorneys, urging the clients that they are supposed to be defending into signing the consent order. Signing the order will have many grave consequences http://woundedhealersnc.net/documents/lip/index.htm. As a hapless victim, I had no concept of such unethical yet commonplace activities.

There is documentation of an extremely arbitrary nature of punishments on www.woundedhealersnc.net ; A physician and his mid-level go out to a dinner presentation by the local pharmaceutical representative. Driving home afterwards, the physician crashes the vehicle. Both are intoxicated. The mid-level spends 2 weeks recuperating in the hospital. The physician/driver gets a “Public Letter of Concern”.

Another physician is out of state on vacation, gets a DUI, truthfully reports it during his annual license renewal and is taken out of practice for four years. Some practitioners NEVER return to practice. Substance abuse issues are treated extremely harshly.

Killed somebody with negligence? Oh, no problem, that will only get you a “Public Letter of Concern” in North Carolina.

You were seduced by a patient? Big problem! There’s to much of a “power imbalance” since you’re a medical practitioner, mid-level or otherwise. You may possibly NEVER practice medicine again. There’s documentation of a psychiatrist who married a patient, the State Board found out about it and took her license away; she was to much of a risk for sexually assaulting other patients. Ultimately she was allowed to have her license back on the condition that she never practice psychiatry again!

I was also unaware that state boards are incentivized to discipline as many physicians as possible, as harshly as possible, for as long as possible.

I was indeed one of the innocents.

Knowledge is indisputably power. The site quoted above provides a wealth of information of the workings of the “system” in North Carolina. The “Great North State” is hardly alone in their approach.

The Physician Health Programs (PHP’s) are another area of concern. It’s a shame that the stated purpose of the PHP’s is to help return impaired practitioners to active practice. These groups throw the very physicians who need help the most the furthest under the bus in full collusion with the Board. They’re typically staffed by psychiatrists who are members of “addiction societies” that aren’t much more than diploma mills. The PHP’s often claim to be performing “peer review” while disregarding the legal requirements for peer review. The PHP’s/Medical Societies/State Boards are parasitic symbionts that prey upon those of us who have been used up and burnt out by the non-system of healthcare that exists.

Does this sound like a pattern is developing? “Disregarding the legal requirements…”

In North Carolina, the complaints were of such a volume that the NCPHP was audited and found to have numerous deficiencies. Next, all 57 of their licensing and professional boards were audited. All of them showed problems—the most common that they did not report to anybody for supervision! These are routine violations of the General Statutes of the state.

Every state has a state auditor whose function is to ensure that state agencies fulfill their assigned duties efficiently and honestly. Most State Medical Boards and PHP’s have NEVER been audited. Anybody can report their concerns to their state auditor.

Attorneys are supposed to uphold the law; isn’t this ironic?

There is ample evidence of collusion among the players; Defense attorneys who should be defending their clients against their Board (sometimes the Boards actually recommend individual attorneys that they “work well together” with to wayward licensees). Board Attorneys are clearly involved as are the PHP’s.

State Medical Societies are also generally in the same bed with the Boards & PHP’s. Governor’s generally rely on the Societies to recommend prospective Board members. It’s not uncommon for the first question at an “investigative hearing” to request information on whether the licensee is a member of the local state society. What would the purpose of such a question be? Simple. It’s well-documented that membership has a “protective” function. It’s not absolute, but exists nonetheless.

In one case, the Board remanded a full mental health evaluation. The result was that the licensee had a mild autism spectrum syndrome (something a good many of us have), an autism spectrum disorder that is characterized by difficulties with social skills and non-verbal communication—but with benefits such as intense interest and expertise in certain areas (like medicine!).

The function of a Board is to maintain scope of practice. Family physicians don’t do craniotomies. Yet, despite the absence of a single mental health professional on the Board, the recommendations of 3 independent professional organizations, all recommending immediate return to practice for the licensee were ignored.

The Board posted the practitioners protected health information, including mental health information on their website. The most basic rights to privacy were clearly violated. The licensee never gave permission for such an intrusion!

The ADA covered disability was dealt with by an indefinite suspension—all with the full collusion of the NCPHP. The ADA requires “reasonable accommodations”. Indefinite suspension is punitive—certainly not a reasonable accommodation! Again, it cannot be over-emphasized that Board attorneys have a strong desire to punish whenever, wherever, for as long as possible.

The licensee signed the contract with the NCPHP. The licensee was held to the terms, but the advocacy mandated by the contract was never delivered; “the Board attorney said he wasn’t interested in anything I have to say in your favor, his mind is made up, there’s nothing I can do to help…” was the limit of advocacy received.

Advocacy?

Collusion is a more accurate description.

The theme song from the hit movie and TV show M*A*S*H* is “Suicide is Painless” by Johnny Mandell. This epidemic is more of an endemic among our profession. We can’t keep “looking the other way”.

There are two major forms of suicide.

Active suicide would best be described as a former colleague who went into the recovery room one Sunday afternoon when it was deserted, took a scalpel and did a full-length carotidotomy on himself. He made a posthumous statement. Another ran out in front of a box truck on the interstate. It took his head off.

Passive suicide is best shown by 5 of the NC Medical Board victims. This Board tends to pursue physicians from their mid-40’s to mid-60’s, the top income-producing time of our careers. They usually have assets to poach. Usually by that age, we’re taking some form of medications for our own health issues. A diabetic who purposely forgoes his insulin… Suicide? It won’t be reported as such. What do YOU think?

We will never eliminate all of our stressors. There will always be the “less fit members of the herd”, which is sad. This is more appropriate for other animals at other positions on the evolutionary tree. Why should the most noble of professions be relegated to those branches of that tree?

We need to reach out to each other. We need to reach out to our state auditors. Another resource that surprised me is a different agency. There is an agency whose primary function is “to deal with corruption in public officials both appointed and elected”.

Does this sound like an appropriate agency to engage against our Boards & PHP’s? It’s the Federal Bureau of Investigation, commonly known as the FBI!

All that it takes for evil to triumph is for good men to do nothing. When we organize we change from individual targets to a formidable force. State Medical Societies, unfortunately, are not the answer. Typically state governor’s turn to them for nominations to staff the boards. In North Carolina, lawsuits have been settled out of court that involve the alliance between the Board, Medical Society & PHP.

Perhaps the best solution would be to revamp the system. Maybe it’s time for a Federal Medical Board. At the very least, State Boards should be restructured so that investigators do not report to the attorneys, but directly to the Board Members. It will mean more work for the Boards, but they’ll at least resume functioning in the manner originally intended.

–Wounded Healer

12/31/2014

This whole lack of accountability and oversight within the PHP’s makes me sick. I was sent to PHP for evaluation and suspicion of drug abuse by my employer hospital. I was only suffering from side effects of Paxil causing a SSRI Discontinuation Syndrome. The diagnosis was completely missed because the PHP sent me to a rehab center in Los Angeles. I am sure you know this one very well.

I was coming there for IDE, Intensive Diagnostic Evaluation not recovery and rehab. After arrival I was forced to enter their rehab program completely against my will. I was on my way out the door and about to call a cab when the program director threatened me with absolute coercion.

He said if I left he would assume I had drugs in my possession and that this would negatively affect my evaluation and would be reported to the PHP and state medical board as a form of noncompliance, and that my career and license would be in jeopardy. How is that possible when I was not sent there by any state board or regulatory agency as I was there voluntarily.

The only incentive to force me into admission rather than having my workup done as an outpatient was purely financial. Employer was paying the bill, so it was in their best financial interest to force me into admission at $1800/day and $1400/urine sample and charge for all the transportation to and from all the outsourced facilities for my “evaluation”.

The facility was run by the most inept, unethical group of charlatans I have ever encountered in any field of service not just healthcare. I could not understand how they were qualified to provide medical evaluations when they are not legally allowed to provide any form of treatment for anything. These people were nothing more than middle-management screw ups. They have to outsource everything. They did not even have a crash cart on site. One of their clients had a tonic-clonic seizure during group therapy as a result of a brilliant PA who decided to withhold the clients chronic benzodiazepine therapy because of her personal beliefs that benzos are horrible medications for anyone. Where is the physician co-signature and oversight on this brilliant therapeutic decision? No one except the doctors in rehab even knew how to react. It was a total fiasco and state of panic for all the rehab employees. Luckily the client didn’t dislocate something, die or worse, suffer anoxic encephalopathy. I was in fear for my life after witnessing this my first day.

What’s even more concerning is that this rehab center is supposedly one of the best and has exclusive referral from every state PHP.

They had me stay with recidivist junkies and participate in 12 step when I had no substance abuse issues at all, in fact my social life was so boring, that my hair test wasn’t even positive for alcohol. I had to recite scriptures in group therapy, admit that I was helpless, and powerless, and a weakling. Admit that I had to submit to a higher power since I was an addict. I had to submit to random urine drug tests which costs $1400 each 3-5 times per week.

Then when I cannot produce a sample on the spot (paruresis) I am threatened to be reported to the State Medical Board for noncompliance. A college dropout working as a technician at a rehab does not even have the authority to make this type of threat. I was also forced to shave in front of a female technician with the bathroom door open; she stated that this was policy and I had to relinquish my razor after every shave because I could use it to inflict harm on myself. I then asked why is there a whole drawer full of sharp cutlery in the kitchen that me and my junkie roommates have access to 24/7???

I saw a psychiatrist and handed him my diagnosis on a silver platter from my history , i.e. Paxil withdrawal yet SSRI Discontinuation Syndrome was not even on his differential. I was in a state of constant agitation, sleep deprivation from insomnia, severe depersonalization. Ended up in the ER at UCLA for intractable Migraine HA, Sleep deprivation, Dehydration, mild AKI and had to be medicated with IV crystalloid, Phenergan to combat emesis and finally induce sleep (going on 4th day of insomnia at that point).

Less than 24 hours after the ER visit I am sent for Neuropsychological testing extensively, which violated just about every code of conduct and ethics under the American Psychological Association in regards to testing validity. I was then labeled “disabled” based on the results. the treatment center was then going to recommend that I stay and additional extended period so they could “rehabilitate” me. They realized now that they did not have my credit card on file because I refused to provide them with it at admission as my employer, was paying for everything for the first month. Next they discover that I do not have disability insurance, and now know that they have just ruined my life. It will take a minimum of 6 months before I can be retested to prove that I have no cognitive impairment and am not disabled. Now my chances of getting disability insurance in the future are ruined.

The treatment center then released me and I returned home to the PHP. I then had to sign a five year contract, enlist in a drug monitoring contact with “RecoveryTrek” which I had to perjure myself and illegally claim that I was a substance abuser and was in “recovery.” I immediately sought legal counsel because of this nonsense. Shortly into my so called recovery I had to take my Maintenance of Certification Board Exam in Internal Medicine. Passed exceptionally and with ease. How could I be cognitively impaired?

Go figure! The neuropsychological test was readministered locally by a different provider as I told the PHP there was no way I would ever consent to going back to the treatment center. The neuropsychologist was pretty pissed off about everyone’s mismanagement of my case starting with my employer. I tested fine, and then the PHP released me from the program and cleared me to return to work. The entire experience has jaded my enthusiasm in medicine. I had to take almost a year off to reflect on how I was used as a pawn in everyone’s game.

I experienced coercion, collusion, fraud, incompetence, and saw a part of evil in this world that I never new existed. I was a prisoner, starting my day by having to call a monitoring center to see if I had to be drug tested for that day, every day of the week. I was not allowed to leave the state; how can a PHP legally restrict my civil rights this way when I was not under a court order, and not even under state medical board referral? I was not allowed to have a sip of alcohol during my monitoring, even though I had tested negative for any evidence of drug use. I had to meet with board of directors every month and discuss my case, which no one had clue about regarding why I was even in a PHP. This violated all of my rights to privacy regarding my medical condition. The contract that I initially had to sign with the PHP had statements within claiming they could report any information about me to any regulatory agency without even substantiating any facts or validity. This is just a clever way of saying they can lie about you and there is nothing you can do about it legally. There is complete lack of due process. Your civil rights are stripped. You are beaten down into despair and desperation. You are told if you don’t comply your license would be in jeopardy and your career will be over. This cost me thousands of dollars in legal fees, thousands of dollars to be retested and prove I was not impaired, hundreds of dollars each month for PHP dues and random urine drug screening.

I put up with this B.S. for six months, and honestly could not have fulfilled a 5 year contract. If I had not been released (since there was no condition to monitor) I would probably be dead today. I would not be surprised that PHPs have actually caused in increase in physician suicide rate. I cannot fathom the degree of humility physicians experience having to do this for five years. And the only reason these rehab centers claim such a high success rate for recovery is that they hold a gun to your head and threaten you to be in compliance with everything they recommend. So yeah, doctors have a lot more to lose. I now understand how these PHP’s are in collusion with rehab centers. What they are doing is a violation of fair trade acts and would fall under the RICO act. The problem is nobody is investigating them for conspiracy and fraud. They all fly under the radar because they believe they are providing a service that ensures public safety. Its a multi-billion dollar scam industry. What’s more sad is that nobody really cares what physicians are subjected to. In fact the public likely finds joy in fact that docs are treated this way. The state of California hates doctors, so the rest of the country probably does too. People probably enjoy knowing doctors are held to higher standards than the rest. That they are usually required to stay 90 days in rehab while all other professionals stay 28 days, that they are financially ruined by rehab centers. That they have been stripped of all their rights while in a PHP monitoring program. That they are more subject to discrimination based on age or coexisting medical problems like diabetes and hypertension. I have actually seen cases of MDs sent to PHPs for monitoring of hypertension and regardless of why you are sent there you must comply with drug monitoring.

The rehab centers are now tapping into other territory that further identify this as a conspiracy. Department of Transportation, Aviation, and Law Enforcement are going to be their next victims. I can’t wait to see how the police officers are going to respond to this nonsense.

This was an eye opening experience. There is no profession that is worth going through this amount of humility. PHP’s will likely remain above the law, continue to have no accountability and oversight, which is a travesty of justice. I hope you will share my experience. My case is rather unique in my opinion. It’s evidence that no physician should ever voluntarily enter a PHP at an employer’s request. You would be much better off to simply quit/resign.

12/27/2014

I know of pharmacist who are forced into the program and held hostage by their license. They are also required to do “inpatient” treatments of at least three months and continued random monitoring for five years as well.

Once they have you by the proverbial ball, they milk you till you are dry. It is nothing but a scam. The funny thing is that for healthcare professionals who relapse while in the program, they are sent back to “rehab”(inpatient) again once more for milking while they feed you the same b.s. they did the first time.

What is becoming even more alarming is that at least in one case, Texas, if you call PHP for help or to inquire about help, even though nothing has been reported at work or to the board, and you identify yourself and spill your guts about your issue/s asking for your options you are automatically signing up for a trip to rehab and five years of monitoring.

If you decided that you are not interested what they have to offer, they will tell you they would report you to the board at that stage (of course at the beginning of the conversation they tell you it is confidential, but it is confidential as long as you voluntarily start their program since you spilled the beans.

I would be very careful calling the state PHPs asking for information. I would do it from a blocked phone and use an alias before talking to them.

Maybe others who information about other states can also shed some light on this.

12/7/2014

It is really tragic that so many valuable doctors are lost without reason. That State Medical Boards can strip a physician of his hard earned license without due process. That there is no oversite of these boards. That boards and PHPs bully and harass physicians, even to the point of suicide. About 400 physician commit suicide every year. That’s a loss of an entire medical school every year! A colleague of mine committed suicide after facing medical board charges that had no signifigance anyway. This is occurring in the face of a physician shortage as baby boomers age.

12/30/2014

Turns out, I am one of those recovering alcoholics (9+ years) with a lot of experience in AA. It was a large part, though not all, of my treatment. I found it personally helped me a lot. And I also agree with your position.

Based on my experience in AA, things I heard at AA meetings and things I read in AA literature:

– the AA message should be spread via “attraction, rather than promotion”

– AA does not claim to be any kind monopoly in the field of addiction treatment

– AA is fully self-supporting, declining outside contributions

– AA is not professional and not organized

And so having a large body of physicians outside of AA promoting AA is, in my opinion, contrary to multiple AA traditions – particularly if this situation creates controversy. I personally find AA needs no extra promotion, and alternative treatment programs ought to be encouraged just as well as further scientific research into the addiction problem.

The whole thing was meant as a very open, welcoming, non-judgemental, informal gathering of alcoholics talking to each other. Extremism, government coercion, public promotion, money – all those things do a lot more harm than good.

At any rate, thanks for your thoughts, Dr. Langan. Best of luck in the future, I’ll keep following along.

12/25/2014

As an airline pilot who made the monumental mistake of believing that the “E” in EAP (Employee Assistance Program) really meant “assistance”, I can only nod my head in sad agreement to everything above. Between “treatment” (indoctrination in AA dogma) and monitoring my decision to ask for assistance in dealing with a series of health and personal issues that I (for the first and so far only time in my life) tried to use alcohol to numb has changed my life forever. I have lost 7 years of my life. My faith in the rule of law in our society is completely gone. The stress and humiliation of having my career depend on my ability to convince people in this program that I have been “converted” (let’s call it what it is: living a lie) have been indescribably painful. It has affected every aspect of my life. My physical and mental health has suffered as has my personal relationships. My only hope is that court decisions like the recent one in the Hazle trial will once and for all end this damaging and unconstitutional practice.

12/1/2014

Comment: Excellent research. What is astounding is that some (if not all) PHPs are using EtGs and EtSs and PEths DESPITE explicit advisories by SAMHSA over a span of 6 years! These advisories noted that a) they were not FDA approved; b) there was insufficient research; c) that there were too many false positives; and d) using such tests in such a setting as the forensic environment where someone’s career and reputation could be put at risk was highly dangerous. Further, as I discovered only recently, NCPHP not only runs these tests on new evaluations it conducts on involuntary (and unsuspecting) physicians who have been ordered (under specious circumstances) to be evaluated by NCPHP, NCPHP adamantly refused to release the results of the tests to the physician, though you can be assured the results were used to “make their case” for a pre-determined diagnosis.

I think it is fair to say that their use of these tests is not simply unethical; it constitutes highly risky human experimentation conducted with neither the subject’s consent nor with approval of an IRB.

One can also presume that PHPs have sold this junk science to their associated medical boards in giving them what appears to be substantial evidence to bolster their case. And one can also presume that medical boards have simply accepted it as though it were valid, essentially doing nothing to challenge the invalidity of the test and the violation of due process and thus virtually rubber-stamping the annihilation of a physician’s career.

When you engage these research epidemiologists in this endeavor (is there yet a group called “Epidemiologists for Social Responsibility?”), you may also ask them to review data form board and PHP actions in which this data was – in any way – involved in the assessment of their case, whether playing a major role or only an incidental one. The introduction of this misleading – and therefore fraudulent – laboratory data into these physicians’ adjudication would seem to serve as a solid basis for invalidating their fraudulent assessment and ensuing “conviction.”

Personally, I believe this is of such immense importance that it ranks up there with the flawed hair and fiber analysis assessments that were done by the FBI which my courageous colleague Dr. Fred Whitehurst called attention to in the late ’90’s (and lost his job over, via a massive campaign of discrediting and innuendo of “mental illness.”) It took nearly 15 years but finally, the DOJ saw the immensity and breadth of the false prosecution based on flawed “evidence” and ordered the FBI to reopen over 21,000 cases of potentially flawed hair and fiber analysis!

I truly believe the same outcome is going to materialize here – it has to! Physicians (and soon many other seemingly well-paid professionals who are judged able to afford the “private addictions treatment for professionals” scam) have been falsely assessed and compelled into costly (and embarrassing) treatment programs and prolonged monitoring (with extra time for balking – i.e. “being disruptive”) by the PHP prison-industrial complex. All with no chance of fair hearing, no chance to challenge the validity of the evidence, and high likelihood of reprisal if one doesn’t “go along.” This pervasive abuse of authority and process must be aggressively confronted.

11/27/2014

Great site! There is so much corruption in medical boards & PHP’s. We need to take it upon ourselves to evaluate what our agencies are doing and turn them into the state auditor of every sight for performance and forensic auditing. Auditors DO listen and DO investigate, but they need to be led to the need for an audit. The best way to do this is for those of us who have been assaulted and battered by these agencies to document what has been done to ourselves and our peers and let the auditors know what is going on!

11/22/2014

I have enjoyed reading your web log. I have empathy for your plight. I am involved in a parallel organization known as the HIMS program (Human Intervention and Motivational Study)

I can’t help but notice that several of the names you have listed under ‘like-minded docs’, are ‘professionals’ I have also encountered. Namely, Joe Garbely who did my initial psychiatric evaluation, Lynn Hankes, a urologist who advises HIMS and the FAA, and William Green, my current psychiatrist. I am told a component of my $1500 dollar meeting with Dr Green (Physical and Psychiatric) will be composed of inquisitions into my involvement in Alcoholics Anonymous and progress in my step work. This is the man who told me I must attend three AA meetings weekly and my aftercare group therapy must involve AA in order to be approved for FAA Special Issuance (the FAA Gold Standard). I was also informed that non compliance would mean a rejection of my application by the Feds. All of this after I informed Dr. Green that there simply was ‘no correlation’ between Alcoholics Anonymous involvement and my sobriety and that I found the program to be psychologically harmful to my well being.

If you have any further information on the three ‘like-minded docs’ I have encountered in my journey kindly point this out to me. I am sure there are more but I must thank you for providing the missing pieces of the puzzle from the medical perspective. Its eye opening to say the least. Have you spoken with the same attorneys the pilots have? I am sympathetic with your plight. The worst mistake I ever made was asking for help and the process of psychological hazing, indoctrination, and coercion did nothing but steepen my situational depression.

Jonathan

Thank you for your earnest work on this subject. We are not alone in this.

Jonathan

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90 thoughts on “Letters From Those Abused and Afraid”

Johnathan:
If you haven’t read The Lucifer Effect, it’s documentation of the Stanford Prison Experiment may be relevant. It sounds as though the staff at these facilities may be suffering from the syndromes described in the report. Intervention may be necessary for their benefit as well as for the benefit of the patients.
Brian

Thanks Brian, I am familiar with the book but have not read it. I think that the Lucifer effect (when good people turn bad and those of conscience are swayed into acting immorally) is at play here. The Physician Health Program system involves three entities; The PHPs, “PHP-approved” assessment and treatment centers and regulatory bodies (medical boards) I believe there is a high percentage of sociopathy in those who are in charge (much more than estimated in corporate psychopathy). The state PHPs essentially voted out or did not renew the contracts of doctors of ethical integrity and moral compass over time. Their replacement seem to be either of like mind or easily swayed into the fold. From what has been reported to me the population of those involved in state PHPS consists of sociopaths, bullies and evangelical 12-step zealots. Their patient reviews prior to joining PHPs are very revealing–a common theme seems to be paternalistic treatment, closed-mindedness, control issues and mediocrity in the profession. So a lot of them were previously doctors who had very little power in the practice of medicine who are then given power over other doctors with no regulation or accountability. They then enjoy that power and given encouragement and approval by the prevailing groupthink they become malevolent and abuse this power without compunction.

Michael:
You’ve revealed so much here. I’m just wondering whether the story would be enhanced by getting the viewpoint of disgruntled or disgraced employees. They may have corroborating testimony regarding the tyrannical behavior of the supervisors. And any allegations of employee abuse that could be provided by doctors in treatment could might create another angle of attack against these institutions, and provide corroboration of claims recorded here.

Then again, this might be a distraction if your campaign is otherwise gaining steam.
Brian

Former employees are threatened with heavy litigation under “peer-review” statutes and confidentiality agreements that if they divulge any information regarding the treatment of monitored physicians. Drs. John Knight and J. Wesley Boyd published an article in the Journal of the American Society of Addiction Medicine addressing the issues but it is heavily bowdlerized and a very watered down version of the original. Even this diluted, however, they were able to get in print the fact that these assessment centers will “consciously or otherwise tailor a diagnosis and recommendations” based on the impression of the PHP. Of course consciously “tailoring ” a diagnosis is fraud. In this context it is the political abuse of psychiatry. They also kept in the fact that the “research” done on doctors (which involves the unvalidated non-FDA approved testing) lacks informed consent and is in violation of the Nuremberg Code regarding experimentation. No accountability to anyone.

The Like Minded Docs I know, Gary Carr and Scott Hambleden, have each been through rehab eight times. Gary Carr was fired as head of the PHP as a result of the obvious failure of drug and alcohol treatment to resolve any of his addiction issues or personality disorders. He then managed to get hired in Washington State, as head of their PHP. He left there at their request. He is currently pushing “Project Blueprint,” and I heard he was monitoring veterinarians. Scott H. was a counselor at Pine Grove – where your stay is indefinite and you are subjected to polygraph testing to assess your compliance. I tried to stick it out, but I became deeply depressed at the daily phone calls for drug testing and the forced adherence to the AA cult. My appointed drug and alcohol counselor (appointed by the PHP) told me I needed “more intensive therapy,” despite the fact that ten weeks did not have a lasting effect on my belief that the system was total crap. The mind control is unethical, and treatment is a long isolation/brainwashing session. Coercion is routine, with threat of public disgrace – everyone believes the medical board. People just don’t realize what is going on, although there has been more coverage in the media lately – Atlantic Monthly, the new documentary called “The Business of Recovery.” The misfits who run the PHPs are, in general, unethical quacks trying to redeem themselves professionally in the only field left to them.Addiction medicine as a specialty is a joke. People with a financial interest or personal stake in AA spend a lot of time and money to stifle scientific inquiry into the effectiveness of these treatment scams.

The reality of this in incomprehensible. I don’t know all the details of Carr’s case but I am guessing after he completed each rehab he was restored to his position of power at the PHP and dispensed swift and certain justice to the noncompliant. He is allowed eight chances while those he is in charge of get none.

Re: PHPs — “I believe there is a high percentage of sociopathy in those who are in charge (much more than estimated in corporate psychopathy).” Not simply more, but *much* more? That’s certainly hard to imagine possible, given the current state of corporate capitalism — quite a frightening thought.

Then we add the incremental replacement of physicians led by some sort of moral compass with the mediocrity “of like mind or easily swayed” – those who aspire to power but cannot wield it with integrity – sans regulation or accountability, and the hour of The Second Coming most certainly seems to have finally “come round at last.” The falcon cannot hear the falconer . . . the centre cannot hold . . .

One clue is to evaluate the backgrounds of the Executive Directors of the state PHPs. Do they have real Boards or vanity Boards? What is their background regarding their own problems with ETOH and substances? How do they personally financially benefit from putting still another Healer into a PHP program?

Missing pieces of the puzzle indeed. I attempted to resign from my union (couldn’t do this…agency shop) I had sent a rather unfortunate intoxicated email to ALPA headquarters in Herndon. This was widely publicized on an internal union web board. This stimulated my entry into the program. My union was negotiating pay cuts for me in a bull market with record profits and a looming pilot shortage. I resented my identity as ‘indentured servant’ to the respective mainline MEC (master executive council) Simply put, I took a pay cut for a bigger airplane, while wide body captains enjoyed the earnest efforts of negotiators to bargain for 20% increases. I was a bit of a union hothead. After my exodus from Fellowship Hall, under unfortunate but serendipitous circumstances, I learned that the psychiatrist was in the process of diagnosing me with borderline personality disorder, a grounding diagnosis. I will look forward to reading the Lucifer Effect. Thank you…

I see a question from a ‘TT Wilson’. He presents a brief case of a physician drunk at work. I am asked how I would recommend the situation be dealt with by PHP.

The physician in question was drunk at work! That’s a problem. And the physician needs to be identified and offered help. How that should be done is another question. And Dr. Langan has outlined the extensive problems with how PHP’s abuse impaired physicians.

My situation is a sad example of how PHP’s etc. are allowed to destroy the lives of physicians who were NEVER impaired at work.

The following is something I wrote on March 6th. I don’t even remember who I was writing to. But it outlines some details specific to my case. And I ask you, ‘TT Wilson’ how you would have handled my case. And I request you include your name, if you have any courage whatsoever. You’ll never have courage like me, of course, but you can do better than writing anonymously.

March 6, 2015:
Let me start with a basic timeline of events. I will include notes which, in my mind, clearly illustrate the depth and breadth of the injustices committed by my tormentors. As I stated earlier, I am still waiting to receive records from WPHP and Talbott. I have NO doubt that my review of these documents will reveal new lies and efforts to suppress the truth. I am confident that I can easily and quickly refute any potential argument ‘they’ may put forth in a pathetic attempt to justify their actions. So my case remains dynamic.

I suffer from severe, recurrent depression. Despite this, I have never been impaired at school, residency or work. And no evidence exists to suggest otherwise.

However, I requested a voluntary leave of absence from work in December 2009 due to an acute episode of depression. This leave was voluntary and initiated well before any occupational impairment was even possible.

I managed to fight through this episode and was ready to return to work in March 2010. As a condition for my return to work, I was referred to WPHP for ‘monitoring’ of my depression (if I only knew what was to follow!)

To be clear, I admitted to a history of recreational drug use. Not abuse. Not dependence. I offered this information freely because I had no reason to mistrust them at that time. And I was not ashamed of my recreational drug use (marijuana). It was a choice made freely. One which never compromised my personal or professional performance.

Before I returned to work, WPHP referred me to a psychiatrist near Seattle (Dr. Steven Juergens). What I know now, and could never have predicted then, is that Dr. Juergens is an addiction specialist. I would certainly have questioned the need for an addiction specialist to re-evaluate me for DEPRESSION. But the nature of the referral was not communicated to me either by WPHP or Dr. Juergens. Of course his obsession with talking about irrelevant drug use at a time when I was desperately looking for help for my depression was confusing and annoying. But at that time I was still pleasantly naive about their true motives. And I was still oblivious to what horrors awaited me.

I signed my contract with WPHP in March 2010, I believe. It included monitoring of my depression by a psychiatrist and a workplace monitor. I was also mandated to meet with WPHP quarterly in Seattle. That is all I remember agreeing to in this contract. I didn’t read it closely. I realized even then that I must do everything they demanded or I would be ‘non compliant’ and removed from work. So, until I get my hands on that contract, I can’t guarantee they didn’t include something about drug testing etc. But it’s irrelevant. And here’s why…Jason Green (my primary ‘case manager’ at WPHP) stated directly to me that THERE WILL BE NO DRUG TESTING! I remember this clearly because it seemed like such an odd thing to say. So irrelevant and confusing. That’s why I remember it. And this was consistent with the fact that they did NOT drug test me for the first 18+ months of my initial contract.

A bit out of order, and brand new information for me is the following: I received my records from Dr Juergens yesterday. Review of these records revealed the following surprises. First, Dr. Juergens diagnosed me with substance abuse! WHAT?! His note is fascinating and illustrative of what you and I already know. This ‘specialist’ gave me a diagnosis, but never bothered to offer ANY evidence to support the diagnosis. In fact, he directly contradicts the diagnosis in the body of his note. This seems very consistent with terminology I discovered today on your website: Political Psychiatry? Can you imagine if ANY other type of physician (other than the almighty addiction ‘specialist’) gave a diagnosis and failed to offer and document evidence to support the diagnosis. Of course, we would be held accountable, disciplined and sued. And rightly so.

Furthermore, to my astonishment, Dr. Juergens recommended that WPHP SHOULD subject me to a program of drug screening. And WPHP completely ignored these recommendations. Again, I did not agree to a program of drug monitoring (although I obviously would have agreed, in part due to my lack of choice, but more importantly because I AM NOT AND NEVER WAS A DRUG ADDICT) And if it was their stated intention that I never use recreational drugs, then I never would have. But…not only did I not willingly sign anything which required me to submit to drug testing, IT WAS EXPLICITLY STATED THAT THERE WOULD BE NO DRUG TESTING. Again, easy to remember because it was such an odd thing to say to a person struggling with depression (Here’s an analogy: a doctor diagnoses a patient with high blood pressure. The doctor then states, ‘but you will not be required to submit to monthly Pap smears!).

From the context clues, you must be aware by now that I WAS eventually FORCED to submit to a drug test, and that I failed. I had used cocaine infrequently and over a short period of time. I do not feel the need to ‘justify’ this drug use. It was, as always, a choice. Drug use is NOT and never should be concluded to be equivalent to abuse or dependence. IT IS NOT. I can read the DSM IV diagnostic criteria. I just wish the ‘specialists’ felt compelled and obligated to read them (and apply them) as well. As you know, this is not the case.

For reasons which I (we) will never know, I was forced, under threat of medical license etc. to submit to a random drug test by Jason Green and Dan Friesen at the WPHP offices around November 4, 2011. I submitted to the test because I had no choice. I also submitted to the test because I was unaware of my rights, if any (as if ANYONE has rights when ensnared by the PHP, right? What a joke!) I also submitted to the test because I WAS NOT A DRUG ADDICT! Of course my urine will be clean. I hadn’t used recreational drugs in months. Then the curveball. They demanded hair. I did not know the significance of this test. I was unaware that they could detects drugs in the hair dating back months.

To summarize the drug testing. To my knowledge, my contract did not authorize drug testing. This is consistent with the direct, confusing statement made by Jason Green when I signed my contract. And it was consistent with the fact that they did not test me until about 20 months after I signed my contract. Why they chose to break their word and contract at that time will never be known. And of course, they will never be compelled to justify it. Furthermore, they ignored the recommendations of Dr. Juergens that I be subjected to random urine testing for a period of 6 months (again, this info just discovered by me five years after the fact). To further confuse the matter, I was never informed that Dr. Juergens was an addiction specialist. His diagnoses and recommendations were never shared with me. Obviously, if I had ANY idea that I would be drug tested, I WOULD NOT HAVE USED RECREATIONAL DRUGS!!! If I had ANY idea that Dr. Juergens had willfully misdiagnosed me with substance abuse, I would have been sufficiently suspicious of them and I WOULD NOT HAVE USED RECREATIONAL DRUGS!!! The breech of contract and medical and ethical abuses here are staggering. I claim that I did not give INFORMED consent for drug testing. I was not informed that ANY failed drug test would result in AUTOMATIC AND IMMEDIATE removal from work and patient care. I was not informed that a positive HAIR test would be used to make a willful and unsupported MISdiagnosis of drug addiction. I was not informed that this same positive HAIR test would result in forced ‘evaluation’ by more ‘specialists’ in Atlanta. AND I WAS NOT INFORMED that the ‘specialists’ in Atlanta had NO intention of ‘evaluating’ me. They made no attempt to justify their WILLFUL misdiagnoses. I was their prisoner. I was their bitch. I have recurring nightmares about the evil cowards at Talbott standing over me. Beating me into submission and grinning. They say ‘Go ahead and scream. NO ONE can hear you. This IS happening. AND YOU ARE POWERLESS TO STOP IT!!!!

But I’m getting ahead of myself. just a couple more things about the initial drug testing at WPHP. What they did to me was worse than willful misdiagnosis and a blatant disregard for medical standards. If they had played fairly…if I had been informed of their intentions…if they made it clear that I must submit to drug testing. If so, I would have protested the inappropriateness of it all, obviously. But I would have ultimately cooperated. I never would have failed a drug test. And I would never have had to endure these abuses and torments and mind rape which have left me without hope. I could have resumed my struggle with the REAL problem…depression. And that is more than enough for any doctor to manage while continuing to meet the challenges of a career in medicine.

But that’s not how it turned out. My forced hair testing was not just unfounded. It was completely unnecessary, had I been treated like any other patient…with dignity, fairness, empathy and COMPETENT care…NONE of this would have ever taken place.

I consider this drug testing to have been surreptitious. It was equivalent to sneaking into my home and taking my hair without my knowledge. And WORST of all…I suffered the civil law equivalent of entrapment. I was told directly that NO DRUG TESTING WILL BE DONE. This is SO MUCH worse than had they just forced me into an unnecessary drug and alcohol monitoring program. That would have been unjustifiable, of course. But it would have spared me this slow death.

I have a million questions for the pitiful cowards who have perpetrated these crimes against me. As do you, Dr. Langan. But let me start with a few: Hey! WPHP Dictators! Why did you not implement the drug monitoring program recommended by your ‘expert’? (He recommended 6 months of random URINE testing). And why was I never informed of his ‘diagnoses’ or recommendations? In fact, I only gave one urine sample during my initial contract with WPHP. And this was more than 18 months after WPHP initially ignored the recommendations of Dr. Juergens. Let’s forget that the urine was obtained without informed consent and in the context of breech of contract, ‘entrapment’ and surreptitious methods. OK, WPHP, final question for now. HOW MANY URINE SCREENS DID I FAIL WHILE UNDER YOUR ‘BENEVOLENT’ ‘SUPERVISION’ AND BEFORE YOU WILLFULLY CHOSE TO RUIN MY REPUTATION, MY CAREER AND MY LIFE????

Correct answer: ZERO

And I have a plot twist. Something which may make my case somewhat unique. And something which puts WPHP and Talbott in an impossible legal position. Any and all arguments they could possibly make to justify a diagnosis of addiction and the forced treatment imposed upon me, will DIRECTLY contradict what they did in the end. OK, here’s a preview…I was released from my 5 year monitoring program with WPHP THREE years early! Despite my continued insistence that I am not an addict, they released me from the program early and have clearly documented successful completion. Here’s the thing…NOTHING has changed! If I was appropriate for ‘early release’ in 2014, then it was inappropriate to ever allow me INTO the program. Either I was NEVER a threat to my patients because of addiction, or they knowingly released an addict who continues to pose a threat to the the same patients they profess to protect. I ‘successfully’ completed their 5+ year program 3 years early, NEVER HAVING GOT PAST ‘Step 1’!! WHAT? See Below:

And Talbotts claim that I was successfully treated is beyond absurd. Have they not read the 12 steps (to which they prostrate themselves in religious reverence) recently? Apparently not. If so, they would know I could NEVER be successfully treated there. Because I could NEVER get past step 1. I could NEVER (willingly and honestly) admit to a lie! that I was powerless to alcohol and or drugs. And I NEVER did (except on two occasions when the lie was necessary to get back to work) So either I’m NOT AND NEVER WAS powerless to alcohol and or drugs, or they knowingly released an active addict (with a most severe case of denial) ‘back to the wild’ to endanger the poor unwitting patients of the state of Washington.

More to come

JONATHAN ROOP

Now back to today. I have much more to say about the torture, false imprisonment, extortion and medical negligence committed against me.

Pathetic ‘rebuttals’ from ‘TT Wilson’ are anticipated. You might say…’You used drugs!? How awful. You got what you deserved’. OK then, if one believes that, then one must support a system in which ALL physicians are subjected to surreptitious drug testing and that ALL positive hair tests will result in immediate removal from work and forced ‘treatment’. Do PHP cultists support this policy? If so, they have failed miserably! I know dozens of physicians who choose to use alcohol and or drugs recreationally and responsibly. What makes them different from me? What saved them from my fate? Well, perhaps not ALL physicians should be subjected to such a policy. Maybe only certain physicians with special qualities should be targeted. For me, that special quality was depression. What’s next? physicians with diabetes, obesity, sleep apnea? It’s a slippery slope indeed. What ‘special’ category of physicians will have their rights stripped next?…foreign born? Homosexual? Libertarians? Black? White? Asian? Dwarfs?

Well, I did not choose my depression anymore than one chooses their gender, ethnicity, sexual orientation medical illness etc. But apparently, WPHP, Talbott, TT Wilson etc. have concluded that depression is a valid reason for me to be treated in this very ‘special’ way.

Who’s next, TT Wilson? Your brother with RA? Your friend with psoriasis? Your colleague born in Mexico? Your son with one DUI and NO evidence of alcohol abuse or dependence? Who’s rights are you next willing to trample upon? What other ‘special’ category of physicians ‘deserve’ what happened to me?

The bottom line: Impaired physicians need help. And the ‘help’ they are getting is woefully inadequate, because of people like TT Wilson.

But, more importantly for me…KEEP YOUR INCOMPETENT HANDS OFF DOCTORS LIKE ME AND DR. LANGAN who were NEVER IMPAIRED!!!! OK?

I remember asking Jason Green and Dan Friesen if they had ever talked to any of my patients, colleagues or anyone else who knows me and or had observed me at work. No, of course not. Then WHY did they suggest I was impaired? Honest and intelligent people will never know. Perhaps TT will offer a defense for labeling a physician impaired without any evidence. The only answer I can imagine: They WANTED me to be impaired. It served some interest of theirs. And that they had no reason to consider me impaired seems irrelevant to these monsters. They did it because they wanted it. and they knew they would get away with it.

BTW: I still haven’t received MY records from WPHP which I requested more than 3 weeks ago. And now that I’ve ‘come out’ one can only imagine the desperate modifications they are making even as I write this post.

These people are so corrupt and dishonest. They truly are sociopathic. I recently read about a young doctor who “relapsed,” and took his life rather than face more torment by these quacks. It is unbelievable that this abuse is ongoing. These people should be stripped of licensure. I am optimistic that karma is a bitch. Sorry to hear of your ordeal, it mirrors mine.

Could you let me know the name of the doctor who died? I’m keeping a list and documenting the patterns of abuse –they are all similar scripts – these are one trick ponies with a finite number of trucks up their sleeves-/- that will be their undoing

His name was Greg Miday, an oncology fellow in St. Louis. Pamela Wibble wrote about him, and the article stated that he relapsed- had a positive screen once after almost 5 years of monitoring and was terrified, depressed, suicidal. There is a doctor who was an associated dean of the University of MS Medical Center, John Moffit.He was a respected pediatric allergist and when he became an administrator he was under a lot of stress, the PHP from MS sent him to the Professional Renewal Center for eval – they then forced him to stay there for 3 months of outpatient treatment, and he shot himself in the mouth right before Christmas in 2007, I believe. I know of a couple of depressed docs who were too afraid to get help and killed themselves (depression – one was my neighbor, his wife was having an affair. ) Have you talked to Susan Haney in Oregon – she went through this for years with the Oregon PHP – I think it was disbanded, but she has all sorts of records and information – her website was ORPAG. Thanks for being on this.

The Professional Renewal Center, Acumen and Vanderbilt are the “PHP-approved” assessment centers for disruptive physicians and everyone gets a diagnosis. They frequently use polygraphs and non-validated neuropsych testing and find “character defects.” These are murders not suicides and we need activism to remove them. The medical societies and the AMA need to see a declining membership;

Marworth in Pennsylvania as well. I HAD an assessment from the director of Marworth’s outpatient treatment program when I appealed my suspension to the PA Board of Medicine and they totally discredited it.
I tried to play the game. I actually agreed to a five day “evaluation” at Marworth. I met other healthcare professionals who laughed when I said I would only be there for Five days. When I met with the addictionologist, Dr Winters, he told me outright, “If you think that I am going to recommend you to retain your licensure after five days you are sadly mistaken.” That was after a 50 minute meeting where I told nothing incendiary, except for a remote history of recreational drug use in my teens/20’s! So I thanked him for his time, got my things and left. I NEVER could have foreseen the train wreck that was coming to my world.

I have to undergo an assessment for medical school. I understand these places are really corrupt. Which one do I have the best shot at? Pine Grove/Next Step, Acumen, Professional Renewal Center, or Elmhurst Professionals Proram

For anyone getting an assessment tape record any and all conversations and interviews. Do this in a state that allows covert tape recording (Most do). Check out https://www.youtube.com/channel/UC3s3FP43fBfHUH0rmpb5r4Q which is AAPS a society of physicians who are not sheep and are actively exposing sham peer review (which includes PHP) in litigation and through teaching. Doctors who have no whistle-blower protection are worthless to their patients. Many physicians are willfully blind and will do anything to keep their Golden ticket . Medicine is a Rockefeller business and exploitation of patients and physicians is the Goal.
The good news is that exposing medical corruption will happen if we stick together. Hubris will be the key to their downfall.

I believe their demise is inevitable at this point and only a question of when. One indicator of this is their silence. Nothing but crickets since the BMJ article made them look like fools. They rely on deference and authoritative pronouncements but when faced with the hard direct questions they scatter back into the dark. The propaganda pieces promoting themselves they used to churn out what seemed like every week on Medscape and in other mainstream medical media seems to have dropped to a trickle. There is a recent advertisement disguised as a journal article in the Women’s fashion, health and hair magazine Marie Claire rehashed on the rehab trade site the Fix but that’s about it. Another hilariously improbable portrayal of a fictitious addicted anesthesiologist shooting up su-fentanyl every 45-minutes for almost a year saved by the PHP. Wonder how she hid 24 track marks a day for so long?

Remember why most of us became physicians. We see the utility in sacrificing for our patients as their is nothing more meaningful that service to humanity. Imagine that the evil that exist in those narcissist who have no compunction about destroying good men and women for the love of power (money). I am lucky to have Christian sensibilities that allow me to transcend my anger in lieu of a higher authority but make no mistake as an former military man with the skills for swift retribution are very palpable. Dark to light Q

The devastation these despicable few have caused is unimaginable and the stories I have heard over the past five years are heartbreaking. The common denominator here is that the individuals involved do not have any semblance of conscience or scintilla of basic human decency or moral development and an utter disregard for the grave consequences to others that they have caused. Given the circumstances I am surprised there have not been any instances of violence but as sociopaths they tend to victimize empathic and vulnerable kind and decent doctors and with their ability to read others may screen out those they sense would not take their abuse so passively.

The change if it comes, comes too late for me. The Pennsylvania PHP took away my profession, my identity, without batting an eye because I would not commit to prolonged inpatient therapy at Marworth in PA. I had several evaluations and they meant nothing and actually said, “we don’t know if this is valid, a sister or friend could work there and lie for you”. I was guilty and unable to prove innocence because I was guilty. There was no recourse. The State Medical Board politely listened and evaluated my supporting material, I guess, but they sided w/ the PHP. Then my certifying body shut the door on me even though I had successfully receertified several times, the last being a year before they pulled my certification. I lost SO MUCH, but I made it. I work in the legal profession now. I hope they get what they have coming to them……..

Donna, you are probably better off. By now you understand it is a rigged system The boards ,hospital administrations insurance companies, and PHPs. are all in the pocket of the business of medicine. If you are a patient advocate this creates a hostile work environment which is why physicians especially primary care folks are so unhappy. The minions in charge have plenty of skeletons of their own and the projection from these Narcissists is deafening. A once noble profession is now just part of another corrupt overly inflated business which statistically ends up destroying itself from within. The resentment will corrode your soul so become successful without these fools and retain your integrity. r . Exposing these folks is possible and this is the worse nightmare for any shame driven Narcissist.

Indeed Paul. I tortured myself for several years then I turned my back on it and have distinguished myself in spite of their attempts to label me. My years of success in practice and academia counted for nothing. I was labeled an addict, and a liar be cause every addict is a liar after all. Please keep pushing to expose these narcissistic assholes and show the medical community how nieve they were in placing their trust in these imposters.

Yes, one of their approved facilities diagnosed me with a personality disorder. I asked my psychiatrist of 6 years if he thought I had possibly – any trace – of a personality disorder – he laughed. No. I am seriously really well adjusted (some depression, under control now that I am not dealing with the PHP.) Palmetto stuck me in the lobby to do a 4 hour personality inventory, with people walking back and forth, because they didn’t have an appropriate room in which to test. Who even uses paper and a number 2 pencil. A high school graduate was the addiction counselor who “evaluated” me. Yes, they are murderers.
I feel very fortunate to have come out on the other side. (More or less, not practicing)

I thought I had posted this reply, but apparently not – anyway, agreed! Let me know what I can do to help. I am actually going to contact that Michigan law firm to see if they want to extend their class action.

This Disrupted Physician website is very interesting. References to witchcraft trials and perhaps Franz Kafka’s book THE TRIAL are most appropriate. Careful examination of PHP referrals shows a greater number of cases, and probably greater revenues associated with PHP evaluations on normal, healthy, substance-free physician victims of sham peer reviews. Many fine doctors are allegedly “disruptive” or framed as “personality problems” and perhaps more commonly sent to PHP than overtly addicted physicians. I think that treatments and monitoring for nonsmoking, nondrinking, drug free healthy docs who were in the cross hairs of toxic administrators or economic competitors outnumber addiction referrals at our state PHP. In my case, I was suspended from hospital infectious diseases work wrongfully and suddenly for 10 days some two months after an unexpected death from C difficile colitis. The patient was well and ambulatory when I signed off but developed diarrhea and GI bleeding the day afterwards. The patient died 5 days after I left town and signed off of the case. In a scapegoat peer review 60 days after death, using wrong dates of service, a medical Administrator charged me for negligent histories and physicals for the days I was away. Real reasons? Administration was mad from the previous year when I tried to free our Medical Staff Bylaws from unvalidated ABMS MOC (trademark) retesting programs for already Board-certified diplomates. Administration and an aggressive lead pharmacist also did not want infectious diseases doctors to challenge an unusual vancomycin pharmacy protocol which used daily vancomycin blood level determinations even in patients with stable renal function. With legal immunity from discovery since 1986, toxic hospital administrators and C (corporate)-suite executives use hospital attorneys to bury independent thinking, “uppity” doctors who believe in science and medical evidence in addition to economic costs when we care for our patients. C suite black suits may abuse their power and send innocents into the web of PHP for endless personality tests and studies, costing much time and about $5000/ evaluation. PHP is another tool to keep a charged doctor out of hospital practice (“guilty until proven innocent”), bullied and beaten down, and unable to pursue due process until the PHP turtles complete their reports. The entire process for PHP took 4 months in my case and then 2 months after the hospital administrator submitted false charges to NPDB (Data Bank) and BORM to clear my professional profile. God bless our BORM, they stopped the C Suite witch hunts dead and dropped all hospital charges against me. I was fortunate that our good hospital staff, my colleagues, and internal and external expert witnesses also supported my standard if not excellent levels of medical care throughout the ordeal. As an epidemiologist, however, I suspected conflicting motives from PHP when they would not in good faith reveal the number of physician suicides by age, sex, year, by specialty Board certification status, grandfathered or MOC (trademark), practice type, by PHP engagement, or other risk factors. If data unknown, why would PHP psychiatrists not use their resources to study the problem? Anyhow, physician victim survivors need to reach out and help others bullied by powerful dark forces. PHP and our business executive coaches help us communicate and work better in difficult circumstances. Physicians need not only to improve our behavior in public relations and communications at work, as advocated by PHP and coaches, but also victims need to understand as Rabbi Kushner said that Bad Things Happen To Good People. And PHP needs to help victims become empowered, politically engaged, and fight nefarious circumstances hurting patient care more effectively. PS. The medical hospital administrator pursued about 15 other similar altercations with the medical staff doctors and, with rising legal costs, lost his position 2 years later.

Anyone who comes up against big *anything* in work or in the wild faces psychopathic defensiveness. It makes me wonder if there’s such a thing as corporate self-esteem. The bullying and coercion are surely a sign of the fear that underlies the processes.

Outside screening and periodic audits for psychopathy should be required of all regulatory and administrative authority and it would not only be a better world but save money and increase productivity. Funnels for sociopaths exist in many of these systems.

I think that your concerns about physicians who may be wronged being harassed or wronged. So as a patient I wrote in my blog an idea, a passage told to blow off Stan. I find your commitment to fellow professionals laudable. If you noticed, I carefully left out any identification or reference to the fictional doctor. I am hugely annoyed about the position I am placed in but would not do anything in real life that has not done real damage to me. I look forward to following your blog. Good work.

I know that professionals risk serious physical and mental health problems. The stresses put upon them can be very high. And, I know that a lot of people are subjected to unfair scrutiny. The people who investigate can be incredibly unethical. Over sight for overseers might be a good thing.

Sinical Surgeon
The word of the day is “GESTAPO “, as a noun it is defined as; The German internal security police as organized under the Nazi regime, known for its terrorist methods directed against those suspected of treason or questionable loyalty. As a verb the definition is; Of, relating to, or characteristic of terroristic police methods or operations: gestapo tactics. The verb definition is what I’d like to focus on. When I was accused of wrong doing by a two time relapsing, drug addict, I was referred to the Physicians Health Program (PHP) in my state of practice. Under the guise of an organization set up to help physicians, I was taken back by the change in demeanor of the head of the program, when I refused to enter a recommended treatment facility… for I had been presumed guilty without any due process. I refuted their allegations that I was a drug addict and decided to obtain an attorney to prove my innocence. The whole ordeal was initiated by this relapsing drug addict who got caught using drugs… to save his ass, he came up with stories about a number of people in the community. The police couldn’t find any proof of his allegations towards me so they arrested me on a bogus charge (a KASPAR violation which is giving information about a patient to someone whom is not a patient of yours) I was the first person ever to be charged with that violation in the state. Needless to say, the incompetent police department didn’t do their homework, because the person I gave information to was my patient. Those charges were eventually dropped but not before the police department had requested that the State Medical Board order me to have a hair test (they were alleging that I sold drugs out of my home) I was making 400K a year on average… I don’t think I needed the extra income. Once the PHP got involved, my career as a cardiac surgeon was doomed. When I challenged the allegations and objected to their GESTAPO tactics…, the director of the program told me that they (the PHP) were immune from prosecution for false accusations and that he was going to “bury” me… That he did. I was ordered to give a hair sample, which came back grossly positive (in the range of a heavy daily use). Had I known then what I know now, I would have asked for a DNA match for the hair sample… I know in my heart the sample was tampered with and I now that this evil former drug addict himself, (the director of the PHP), arranged it. From that point on my life has been a living hell… a virtual legal nightmare due to the domino effect that State medical boards employ. I’m still in limbo, my purgatory. I grieve for my fallen career and I prey I continue to have the strength to live and let live. ‪#‎wordofthedayss‬

Dr. Langan, thanks for the follow. I understand (to some degree) the frustration of poor treatment of doctors within their own governing community; only my passion is about abuse in the church. Thanks for the follow. May God’s justice prevail.

Wow—-this is the first time I am coming across this website. I am a nurse anesthetist that has been beaten down and defeated by the powers that be, because I had no other choice. I have read everyone’s posts, and I have also experienced the same exact things. There is no regulatory body that oversees the medical/nursing boards or “programs”, and they can do whatever they want without having to prove any of it. I had to consent to charges of things that I didn’t even do—that I stole a narc prescription pad from the Pyxis, that I stole dilaudid from the Pyxis—-so that I wouldn’t lose my license. It doesn’t really matter that I didn’t lose my license though—-because all of these things are posted on the internet for the world to see, and I can’t get a job as a CRNA or even as a nurse. I am several years past the end of my board action, yet it is still published online. That, in a legal sense, is “continued punishment” in the form of public shaming, which is illegal. But, the boards do not operate according to any legal precedent, and that is the problem. Publishing such humiliating things on their websites for all to see serve no other purpose than to publicly shame & humiliate someone—-yet, they say it is to “protect the public”. I would appreciate it if someone—anyone—could explain to me how this “protects the public” in any way. I am surprised that no medical professional that has had to tolerate the illegal, unjustified and corrupt “money machines” that these programs are has not confronted their state representatives to ask them why these organizations are allowed to function with no oversight, and allowed to ruin so many medical professionals lives for no reason.

Another thing that I have figured out is that by these state board programs turning everything into a drug/alcohol/substance abuse case, not only does it result in an incredible amount of money for the “players”, but it results in the medical professional without a substance abuse issue that is seeking assistance for another problem not getting the appropriate help that they need. Completely ignoring a diagnosis of clinical depression in the absence of any substance abuse, and then pinning the diagnosis of “addict” on that person after they had a glass or two of wine at dinner is the equivalent of negligence and blatant malpractice. If a medical professional made a gross error in diagnosing the way the boards and their bought cronies do all the time, the board would have no problem taking action against them. But, they do it every day and absolutely nothing is done about it. Treating a person with clinical depression for substance abuse and forcing them into a contract/consent order under the threat of losing their license altogether is far worse than negligence/malpractice—it is criminal.

This entire industry that exists between the boards and their “participating” addictionologists, treatment programs, drug testing programs, psychiatric evaluators, etc. must be investigated and blown wide open to reveal what they really are—-a money-driven machine where everybody is taking their piece, well concealed as a program to “guard the safety” and “protect society”. Since it is illegal for a medical professional to refer patients to any diagnostic center or treatment facility in which they have a financial interest, it should be illegal for the boards to order medical professionals to seek evaluations and treatment from only the places they allow. I have been waiting and waiting for some big news story to break where the financial incentives of board members, “evaluators”, treatment facilities and drug testing places are blown wide open and their illegal & corrupt methods are exposed in a wide scale. I don’t know why that hasn’t happened. I have often thought about filing a FOIA request with the state board(s) to find out information about the cases they have dealt with. Then I decide not to, because I couldn’t even get them to provide evidence to prove the charges in my case—-they said that if I demanded to see the evidence, that I would have to go to trial in front of the board. And they also said that they didn’t have to show me any evidence. The sad thing is that we have no choice.

Precisely – we need a revolution but the paucity of interested parties is incomprehensible. Getting anyone interested is like pulling teeth. I’ve given a lot of time in attempting to engage others and the majority has been for naught – nothing left to do but sit back and watch the whole shit house go up in flames.

I think that the healthcare providers that are caught up in the corrupt system are too afraid to say or do anything, and anyone else that isn’t involved doesn’t care. The boards/programs have successfully managed to convince the public that healthcare providers that have done ANYTHING wrong don’t deserve anything other than harsh punishment, and the public agrees. They have also managed to convince the public that all of the healthcare providers that they have ensnared into their system of corruption are guilty—even though the public has no idea that the methods they use to make their determinations are nowhere near related to actual legal process, and the healthcare providers are afforded no method of actually defending themselves because they don’t know what evidence the board/program has to support the charges. The public does not know that many healthcare providers concede to the threats because they don’t want to lose their licenses and their livelihood. There is no motive to change anything with the state boards/programs because nobody except the ones that happened to become trapped in their tangled web care about it. There is no method of opposing a charge, or a positive test or anything else that works against the healthcare provider. There is no regulation of the legality of the methods being used by the boards/programs. Most of the methods used in the system would never fly in a court of law because there has to be a standard of law and those standards are called statutes. The same principles should apply in the administrative law forum of state boards, but it doesn’t. When one’s basic constitutional rights have been stripped and there is no choice but to concede & submit to their corruption, there is nothing left. I am so shocked that no one has ever brought this to the major media outlets or challenged it in a court of law. The bottom line is that you don’t know how corrupt it is until you’ve been forced to comply with their rules. I am surprised that no lawyer has ever recognized that there is a class action lawsuit in every state just waiting to be filed against the state boards for the flagrant misappropriation of “administrative law” in order to financially benefit a certain core of individuals that inter-refer. If any other physician or healthcare provider functioned the way they do, with their “referrals” being only to certain entities that benefit financially from their “relationship”, they’d have to answer to the feds. Why are they allowed to do this without any ramifications? It defies all rational thought.

Michale, a revolution is in the works. I am confident. Take pride in the fact that your voice and this site have been a beacon of hope for so many. Honestly, you have likely saved lives despite not practicing clinically over the past few years. Keep continue to be our voice.

Your hard work has not gone unnoticed by all of us who have had our lives turned upside down, careers and finances destroyed by state medical boards. I, for one, do not have money to help. 9 yrs out of work in my medical specialty is a loss of over 2 million dollars in income, benefits…etc. We’ve lost everything. Even if I *could* afford an expensive & competent atty, I believe the money would be wasted. I’ve read that story many a time.

Your blog has provided a platform for so many wronged professionals. I don’t need more convincing that the system in place is wrong in every way. It needs to be scraped and begun anew. Where and how do we begin to change it? Give us guidance….what can we as a group do to be a voice of power, to embarrass state boards, php’s, the Federation of State Medical Boards…etc?

Do we send a compendium of your blog to the press? We need to focus on action.
Respectfully (and tremendously grateful for what you have created with Disrupted Physician)

May I post this as a question for a blogpost ? I’ll then answer with what I was just writing about – bottom-up activism, silence no more, naming the enemy and a demand for direct answers to direct questions. These carney hucksters and simple minds rely on silence, secrecy and deflection of scrutiny so the next step is to call them out publicly. I plan on challenging Greg Skipper to a public debate facilitated by Medscape and moderated by the ethicist Art Caplan – the topic will be the carnival of drug testing he introduced and the consequences. I will shred him to a nub but I don’t think he has the balls to have a go at it. We need angry mobs and activism now as they are caught off guard. Doris Gunderson came off as a blathering idiot in the BMJ– what was her quote– “we want doctor’s to know we are there for them day and night” or some similar meaningless jabber. We need to hit them hard-they’ve got the money and connections but we got the brains. Let’s take dead aim.

I think the answer to your “why?” is because we think that if we comply, acquiesce, submit and stay silent, justice will prevail. Of course it doesn’t. My privacy, career and reputation have already been damaged beyond repair, so I no longer have a reason to submit. You have some good suggestions re: FOIA or contacting state reps. Personally, I think a class action suit might get the “suits” to pay attention. My research shows that individual suits seldom, if ever, prevail.

I am an RN caught up in the State of Florida’s version of this mess. While yes, I deal with a psychiatric diagnosis (Bipolar 2), up until a single episode of depression that spectacularly manifested itself in a suicide attempt involving a drug overdose (that thankfully failed), I did fantastic. I got through nursing school and had a stellar career. At a certain point, I developed a lot of physical health issue that no doubt precipitated that act. Upon that incident I landed in the PHP mill of evaluation and treatment nightmares, complete with the conflict of interest exactly as stated in other letters.
After a huge amount of money spent on inappropriate drug/alcohol treatment, damage to my relationship with my family, and lopping my career off at the knees, I have been forced to submit to a boilerplate contract that is broad and ambiguous to the point of essentially allowing the program to do what they want, when and how they want. There is a lot of inconsistent interpretation and inconsistent enforcement of their so-called “policy.” (which seem to be invented and changed as they see necessary at the moment.)
With my license and livelihood held hostage, i am forced to submit myself to multiple humiliating tasks. I am coerced to AA meeting attendance, even though I have never even drank. I question how attendance at a religious organization can be required to retain my state-issued license. i will be in this dystopian world for 5 years. I have made it through two and pray that I will get through the next 3.
I do not deny that I needed some type of help when in the throes of that particular down swing, but this was not it. SIX months of drug/alcohol treatment, 12 step indoctrination and the like only served to make my fight even harder.
Thankfully, my medication regimen is well balanced now and I have a fantastic therapist and psychiatrist. Seeing both is a stipulation to the contract and I have no issue with that. I do not take issue with the monitoring aspect so much as i do with the net being cast so wide that very competent professionals with anything from true addiction issues to mental health to merely a penchant for bad judgement (how does a 15 year old DUI make a person an alcoholic.”) are scooped up and dumped in a large bucket and labeled “unsafe to practice.” That bucket is owned and run by these PHPs. To paraphrase a statement I once saw “yes there are people that should not be practicing except under the eye of such a program but there are many, many more whose lives and careers are forever ruined by these harsh and draconian punishments.
The programs claim to “advocate for the impaired nurse.” I see little to no advocacy and a lot of punishment, mostly I believe in the pursuit of the almighty dollar with no care of the fact that there are real human beings on the other end of the rope that is being yanked. It is even worse that the perpetrators of this horror are the physicians that once took an oath “to do no harm.” They must have forgotten that.

This is an international problem. I am representing a client who was erased from the Medical Register in British Columbia even without a notice of enquiry-he did not even know he was being investigated but had fallen foul of a colleague who was close to the Deputy Registrar of College of Physicians. And this statutory body is covered by a statutory immunity! Worst part is that an action even of an arbitrary nature like this is curtains for the physician. I have had extensive correspondence with the FSMB and they are aware of the procedure followed by the College in British Columbia .I have also been in correspondence with the GMC in London. They claim they have no control over the way the College acts in British Columbia. Fine! But why do they give credence to rulings by these rogue regulators! No one has any answers to that. Effectively a bad ruling by a rogue regulator anywhere in the world ensures that the doctor cannot work anywhere.

I am absolutely floored by these letters and comments. While I knew that I wasn’t the only physician/healthcare professional who was put through this ordeal, until I read these posts, I wasn’t aware of the depth and breadth of the problem. Phrases that I used in trying unsuccessfully to defend myself keep appearing in these posts. (Human rights; constitutional rights; due process; use is not the same as abuse, abuse is not the same as addiction; a travesty; a miscarriage of justice; conflicts of interest; violation of privacy; a condition does not equal an impairment;consider the harm to patients from losing their physicians etc.) I shredded up the “consent decree” the Ohio State Medical Board sent me and stuffed it in an envelope with a note: “Here’s my answer”. Shortly thereafter, I started to settle into a mild funk not knowing what to do next, if anything. Unlike many practitioners, I have the freedom of “nothing left to lose” now and these posts have renewed my motivation to persist. I will speak up and I will say my name. Thanks to all of you.

Sadly, I’m having to cut way back on my discretionary expenses. With the expense of complying with the board’s orders etc., I’m in the red. Hopefully better times are on the way. I’ll continue to do what I can in other ways.

I read the last lines of your post as if I was reading something I might have written. My response to a signed consent agreement in another state was much like yours. I didn’t think I wanted to be a doctor any longer. There was no suspension of my license and no restrictions either. I had to complete 13 hrs in a documentation course 1/2 way across the country from where I lived. What a random thing…13 hours, & also how random, a one-size-fits-no one course on “documentation”. I promptly completed the course to make the AZ board happy. I guess they were satisfied because when it came time to renew my license, I could have sent in my $400, signed my name and renewed for the routine two years. But I didn’t. Like you, I descended into a “funk”.

I was humiliated by having a splotch on my record. I was angry that I had signed anything since the “agreement” amounted to a bunch of trumped up nothingness. For 18 months I contemplated how I could make money by 1) writing 2) starting my own online business 3) tutoring. I finally responded to a recruiter’s call one day, interviewed with a hospital, and was offered a generous 4-yr contract with all assurances that licensing would go smoothly since I had no malpractice issues. Wrong. The consent agreement became larger than life. Nearly 8 yrs since I interviewed with that hospital and 10 since working as a physician, I am still trying to find the keys to the kingdom.

Someone can be a horrible doctor – negligent, out-of-date, rude – if he/she knows how to fly below the radar, gets in the minimum number of cme’s, never allows licence(s) to lapse, they’re good to practice. We all know docs out there who have really bad records….malpractice cases; board issues that are not trivial; a history of being anything but good to or for their patients. As long as they keep their licenses renewed and don’t threaten anyone with their knowledge (something an incompetent doc is not likely to do) they’ll go on making money and harming patients. You and I will sit on the sidelines, continuing to fight our way back.

This situation with nurses and the nursing board I can see , are finding corrupt “court whores” (Patricia Hagen – Whores of the court {book} ) and taking nurses down using mental heath . Ordering psych evaluations. All the psych needs to do is order counseling. ANd you are on probation. Forced counseling , for things that never happened, to be “safe to practice” . although practicing for many years without any issue. no drugs alcohol , just dispute in way distant past. They are using , crystal ball future prediction , which psychs are not suppose to do ! the bottom line, when a nurse has a case with a hospital , the board takes the nurse down to distract them with litigation and saving their license they dont have the means to go after the facility. The boards are working in collusion with hospitals .

It has been two months now since I got the final notice coercing me to enter into a
consent Agreement which I refused. I had appealed through a hearing; nothing changed. I had gone before the Ohio State Board to appeal. The Chairman read a prepared statement stating that I was impaired, that I was an alcoholic and addict and that my husband and family were liars and enablers. Again nothing changed. If I didn’t attend an in-patient drug rehab program for at least 28 days then follow a Draconian regimen of follow up for the next 5 years, I would NOT get my OH license back. Today I am trying to decide whether or not to appeal the reciprocal suspension of my Virginia license. There will be a lot of hoops to go through, time, money and expense. But the worst of it is having to re-live the trauma of my struggle against the OH Board. Do I want to put myself through that? Right now I don’t know. Has anyone else done this successfully? Has anyone else even tried? Do you think it’s worth it? I would like to know your experiences and advice.

It’s taken me six months to go from devastated to angry. I can’t make any use of my medical skills without a valid license. I can’t work as an MRO, I can’t do chart reviews, I can’t donate my time and expertise to our local free clinic. But I can write. And I’m beginning to do so. Physicians have no chance individually to sue their Boards, but, working together, we might be able to make headway.. My first step will be a letter that I’m currently composing to the Ohio branch of the ACLU.

On the premise that no governmental entity can give an agency under its auspices the authority to abridge an individual’s or a group’s civil rights, I will list all the civil rights that State Medical Boards violate. Among those are the right to the presumption of innocence, the right to face one’s accuser, equal treatment under the law, protection against unlawful seizure of property, the right to personal physical liberty and the right of freedom from imposition of religious beliefs, among others. State Medical Boards, also flagrant violates the ADA (you don’t have to be an employee to be protected by the ADA.) It also violates PHI when it posts someone’s “supposed” medical conditions to a public website and it clearly violates the rules of evidence by claiming it has “clear and convincing evidence of impairment” when it has NONE at all. These Boards even interfere with one’s absolute right to refuse unnecessary “medical care.” I could use some guidance but I couldn’t then and can’t now afford a lawyer.

G Douglas Talbott was a self-serving leech who manipulated various State Medical Examiner Boards, whose individuals should share his shame. Wherein lies the problem: these agencies close their eyes and hope any potential problem will go away. Talbott offered an easy out for Boards, at his considerable compensation, in contrast to his negative value.
My experience parallels those already on record: psychological and professional rape. I will refrain from the ugly details.
Talbott was an asshole ensconced on a directive throne, supported by a misinformed and uncaring bureaucracy. I recognized that his devastating prerogatives were misconceived and unjustified. And recognized his pursuit of wealth. His insincerity was manifest.
Quite frankly, secure with my own integrity, I never considered suicide. However, I assassinated the bastard many, many times in my imagination. The human excrement on his grave may well be mine.

It has now been a year and half since my Ohio license was revoked, the first domino to fall. Then, in rapid succession, my Virginia license, my professional contract, my board certification and, finally, my DEA license fell down. I have not earned a cent since then. However, I am one of the lucky ones; I was able to retire early, was reunited with my husband and we are living a modest but comfortable lifestyle. However, I am seriously concerned about the plight of resident physicians struggling with student loan debt, those in mid-career who know nothing other than the practice of medicine, who are dealing with an abusive consent decree and those whose mental health has been seriously damaged. These violations of our very human rights must be exposed before any meaningful reform will occur. I have nothing to lose by fighting for the rights of my colleagues and feel duty bound to take a stand. My wish is that the State Medical Board of Ohio will eventually learn that they picked on the wrong person and that the domino effect will cause every state board that abuses its licensees to fall flat on their faces. Anne Phelan-Adams MD